Health Status and Individual Care Needs of Disabled Elderly at Home in Different Types of Care
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Patients
2.3. Measures and Variables
2.3.1. Health Status
2.3.2. Health Outcomes
2.3.3. Individual Care Needs
2.4. Statistical Analysis
3. Results
3.1. Basic Characteristics of the Disabled Elderly
3.2. Disease Status and Health Behaviors of Disabled Elderly in Different Types of Care
3.3. Health Outcomes of Disabled Elderly in Different Types of Care
3.4. Individual Care Needs for Disabled Elderly in Different Types of Care
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Participants (n = 559) | Characteristics | Participants (n = 559) | ||
---|---|---|---|---|---|
n/mean | %/SD | n/mean | %/SD | ||
Gender | Source of income | ||||
Male | 313 | 56.0 | Pension or Annuity | 485 | 86.8 |
Female | 246 | 44.0 | Government or social relief | 50 | 8.9 |
Age (year) 1 | 70.2 | 8.3 | Family support | 24 | 4.3 |
Age group | Basic medical insurance type | ||||
60~69 | 337 | 60.3 | for urban workers | 305 | 54.6 |
70~79 | 121 | 21.6 | for residents | 254 | 45.4 |
≥80 | 101 | 18.1 | BMI (Kg/m2) 1 | 23.4 | 3.8 |
Household registration | BMI group | ||||
Rural | 95 | 17.0 | <18.5 | 48 | 8.6 |
Urban | 464 | 83.0 | 18.5~23.9 | 280 | 50.1 |
Marital Status | 24~27.5 | 171 | 30.6 | ||
Married | 385 | 68.9 | ≥27.5 | 60 | 10.7 |
Unmarried | 84 | 15.0 | Disability type | ||
Divorced or widowed | 90 | 16.1 | Visual | 64 | 11.4 |
Education | Hearing and Speech | 51 | 9.1 | ||
Primary School or below | 174 | 31.1 | Physical | 327 | 58.5 |
Middle School | 220 | 39.4 | Intellectual | 76 | 13.6 |
High School or Technical Secondary School | 117 | 20.9 | Mental | 30 | 5.4 |
Multiple | 11 | 2.0 | |||
Junior College or above | 48 | 8.6 | Disability severity | ||
Occupational Status | Level 1 | 130 | 23.3 | ||
On the job | 55 | 9.8 | Level 2 | 241 | 43.1 |
Retirement | 463 | 82.8 | Level 3 | 105 | 18.8 |
Unemployed | 41 | 7.4 | Level 4 | 83 | 14.8 |
Monthly household income ($) | Disability duration (year) 1 | 29.4 | 23.5 | ||
<150 | 15 | 2.7 | Type of care | ||
150~449 | 163 | 29.1 | Self-care | 193 | 34.5 |
450~749 | 329 | 58.9 | Family-care | 139 | 24.9 |
≥750 | 52 | 9.3 | Family-care & Public-care | 227 | 40.6 |
Variables | Total (n = 559) | Type of Care | p Value | ||
---|---|---|---|---|---|
Self-Care (n = 193) | Family-Care (n = 139) | Family-Care & Public-Care (n = 227) | |||
Chronic disease | 0.10 | ||||
yes | 261 (46.7) | 81 (42.0) | 62 (44.6) | 118 (52.0) | |
no | 298 (53.3) | 112 (58.0) | 77 (55.4) | 109 (48.0) | |
Number of diagnoses 1 | 1.0 (1.3) | 0.9 (1.2) | 1.0 (1.4) | 1.2 (1.5) | 0.03 |
Main disease | |||||
hypertension | 178 (31.8) | 56 (29.0) | 44 (31.7) | 78 (34.4) | 0.50 |
diabetes | 81 (14.4) | 23 (11.9) | 16 (11.5) | 42 (18.5) | 0.08 |
COPD 2 | 5 (0.8) | 2 (1.0) | 1 (0.7) | 2 (0.9) | 0.95 |
chronic pneumonia | 4 (0.7) | 1 (0.5) | 1 (0.7) | 2 (0.9) | 0.91 |
chronic bronchitis | 31 (5.5) | 9 (4.7) | 13 (9.4) | 9 (4.0) | 0.07 |
CHD 3 | 40 (7.1) | 11 (5.7) | 11 (7.9) | 18 (7.9) | 0.63 |
cerebral hemorrhage | 6 (1.0) | 0 (0) | 1 (0.7) | 5 (2.2) | 0.08 |
cerebral infarction | 43 (7.6) | 10 (5.2) | 7 (5.0) | 26 (11.5) | 0.02 |
cataract | 52 (9.3) | 12 (6.2) | 19 (13.7) | 21 (9.3) | 0.07 |
glaucoma | 7 (1.2) | 2 (1.0) | 3 (2.2) | 2 (0.9) | 0.54 |
arthritis | 41 (7.3) | 12 (6.2) | 6 (4.3) | 23 (10.1) | 0.09 |
rheumatism | 17 (3.0) | 1 (0.5) | 7 (5.0) | 9 (4.0) | 0.03 |
advanced tumor | 10 (1.7) | 2 (1.0) | 1 (0.7) | 7 (3.1) | 0.16 |
Smoking | 0.009 | ||||
yes | 87 (15.6) | 42 (21.8) | 20 (14.4) | 25 (11.0) | |
no | 472 (84.4) | 151 (78.2) | 119 (85.6) | 202 (89.0) | |
Drinking | 0.016 | ||||
yes | 68 (12.2) | 34 (17.6) | 14 (10.1) | 20 (8.8) | |
no | 491 (87.8) | 159 (82.4) | 125 (89.9) | 207 (91.2) | |
Taking exercise | 0.001 | ||||
yes | 182 (32.6) | 82 (42.5) | 39 (28.1) | 61 (26.9) | |
no | 377 (67.4) | 111 (57.5) | 100 (71.9) | 166 (73.1) |
Variables | Total (n = 559) | Type of Care | p Value | ||
---|---|---|---|---|---|
Self-Care (n = 193) | Family-Care (n = 139) | Family-Care & Public-Care (n = 227) | |||
ADL 1 | |||||
Total points 2 | 29.1 (11.5) | 22.1 (6.5) | 27.6 (9.1) | 36.0 (12.3) | <0.0001 |
Ranking points | <0.0001 | ||||
Self-care ability | 46 (8.2) | 32 (16.6) | 6 (4.3) | 8 (3.5) | |
Function declines | 145 (26.0) | 78 (40.4) | 37 (26.6) | 30 (13.2) | |
Dysfunction | 368 (65.8) | 83 (43.0) | 96 (69.1) | 189 (83.3) | |
Mental health (GHQ−12 3) | |||||
Total points 2 | 7.5 (8.1) | 8.1 (6.6) | 8.0 (8.1) | 6.7 (9.3) | 0.006 |
Ranking points | 0.05 | ||||
Low-risk | 479 (85.7) | 175 (90.7) | 115 (82.7) | 189 (83.3) | |
Medium-risk | 38 (6.8) | 11 (5.7) | 13 (9.4) | 14 (6.2) | |
High-risk | 42 (7.5) | 7 (3.6) | 11 (7.9) | 24 (10.5) | |
Quality of life (SF−12 4) | |||||
PCS 2 | 32.8 (8.8) | 37.6 (8.5) | 30.7 (7.7) | 30.0 (8.0) | <0.0001 |
MCS 2 | 46.5 (11.8) | 50.3 (10.3) | 46.7 (12.0) | 43.2 (12.1) | <0.0001 |
Care Services Items | Total (n = 559) | Type of Care | p Value | ||
---|---|---|---|---|---|
Self-Care (n = 193) | Family-Care (n = 139) | Family-Care & Public-Care (n = 227) | |||
Basic living support | |||||
Housekeeping (BLS−1) | 435 (77.8) | 133 (68.9) | 112 (80.6) | 190 (83.7) | 0.001 |
Physical Care (BLS−2) | 415 (74.2) | 132 (68.4) | 101 (72.7) | 182 (80.2) | 0.02 |
Economic subsidy (BLS−3) | 437 (78.2) | 134 (69.4) | 112 (80.6) | 191 (84.1) | 0.001 |
Housing retrofit (BLS−4) | 418 (74.8) | 132 (68.4) | 105 (75.5) | 181 (79.7) | 0.02 |
Medical and nursing support | |||||
Escort to hospital (MNS−1) | 419 (75.0) | 134 (69.4) | 105 (75.5) | 180 (79.3) | 0.06 |
Medical service (MNS−2) | 426 (76.2) | 134 (69.4) | 108 (77.7) | 184 (81.1) | 0.01 |
Care and Rehabilitation (MNS−3) | 420 (75.1) | 133 (68.9) | 104 (74.8) | 183 (75.1) | 0.02 |
Emergency rescue (MNS−4) | 433 (77.5) | 135 (69.9) | 114 (82.0) | 184 (81.1) | 0.008 |
Social participation support | |||||
Assistive devices rental (SPS−1) | 388 (69.4) | 132 (68.4) | 99 (71.2) | 157 (69.2) | 0.85 |
Public activity space (SPS−2) | 404 (72.3) | 134 (69.4) | 106 (76.3) | 164 (72.2) | 0.39 |
Recreational activities (SPS−3) | 399 (71.4) | 134 (69.4) | 104 (74.8) | 161 (70.9) | 0.55 |
Psychological support | |||||
Phone or home visit (PS−1) | 403 (72.1) | 134 (69.4) | 99 (71.2) | 170 (74.9) | 0.45 |
Interactive activities (PS−2) | 396 (70.8) | 133 (68.9) | 98 (70.5) | 165 (72.7) | 0.69 |
Psychological counseling by hotline (PS−3) | 391 (69.9) | 132 (68.4) | 95 (68.3) | 164 (72.2) | 0.62 |
Care Services Items | Total | Type of Care | p Value | ||
---|---|---|---|---|---|
Self-Care | Family-Care | Family-Care & Public-Care | |||
Basic living support | |||||
Housekeeping (BLS−1) | 91 (20.9) | 32 (24.1) | 22 (19.6) | 37 (19.5) | 0.57 |
Physical Care (BLS−2) | 91 (21.9) | 32 (24.2) | 17 (16.8) | 42 (23.1) | 0.35 |
Economic subsidy (BLS−3) | 85 (19.5) | 32 (23.9) | 22 (19.6) | 31 (16.2) | 0.23 |
Housing retrofit (BLS−4) | 76 (18.2) | 32 (24.2) | 19 (18.1) | 25 (13.8) | 0.06 |
Medical and nursing support | |||||
Escort to hospital (MNS−1) | 85 (20.3) | 32 (23.9) | 18 (17.1) | 35 (19.4) | 0.41 |
Medical service (MNS−2) | 84 (19.7) | 32 (23.9) | 20 (18.5) | 32 (17.4) | 0.33 |
Care and Rehabilitation (MNS−3) | 76 (18.1) | 31 (23.3) | 17 (16.3) | 28 (15.3) | 0.16 |
Emergency rescue (MNS−4) | 80 (18.5) | 31 (23.0) | 19 (16.7) | 30 (16.3) | 0.27 |
Social participation support | |||||
Assistive devices rental (SPS−1) | 74 (19.1) | 31 (23.5) | 22 (22.2) | 21 (13.4) | 0.06 |
Public activity space (SPS−2) | 74 (18.3) | 32 (23.9) | 20 (18.9) | 22 (13.4) | 0.07 |
Recreational activities (SPS−3) | 74 (18.5) | 32 (23.9) | 20 (19.2) | 22 (13.7) | 0.08 |
Psychological support | |||||
Phone or home visit (PS−1) | 78 (19.4) | 31 (23.1) | 22 (22.2) | 25 (14.7) | 0.13 |
Interactive activities (PS−2) | 71 (17.9) | 31 (23.3) | 18 (18.4) | 22 (13.3) | 0.08 |
Psychological counseling by hotline (PS−3) | 70 (17.9) | 31 (23.5) | 18 (18.9) | 21 (12.8) | 0.06 |
Care Services Program Code | BLS−1 | BLS−2 | BLS−3 | BLS−4 | MNS−1 | MNS−2 | MNS−3 | MNS−4 | SPS−1 | SPS−2 | SPS−3 | PS−1 | PS−2 | PS−3 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
BLS−1 | 313 | 282 | 290 | 281 | 278 | 280 | 282 | 279 | 249 | 258 | 255 | 258 | 260 | 256 |
BLS−2 | 282 | 289 | 273 | 267 | 266 | 272 | 271 | 265 | 241 | 245 | 247 | 248 | 248 | 247 |
BLS−3 | 290 | 273 | 319 | 284 | 275 | 280 | 286 | 282 | 249 | 265 | 261 | 259 | 259 | 254 |
BLS−4 | 281 | 267 | 284 | 303 | 268 | 275 | 275 | 272 | 249 | 256 | 252 | 255 | 254 | 252 |
MNS−1 | 278 | 266 | 275 | 268 | 301 | 287 | 289 | 288 | 252 | 260 | 260 | 260 | 262 | 257 |
MNS−2 | 280 | 272 | 280 | 275 | 287 | 304 | 295 | 289 | 256 | 264 | 263 | 266 | 265 | 263 |
MNS−3 | 282 | 271 | 286 | 275 | 289 | 295 | 309 | 292 | 257 | 268 | 267 | 267 | 267 | 263 |
MNS−4 | 279 | 265 | 282 | 272 | 288 | 289 | 292 | 312 | 256 | 268 | 265 | 268 | 264 | 262 |
SPS−1 | 249 | 241 | 249 | 249 | 252 | 256 | 257 | 256 | 265 | 251 | 253 | 249 | 249 | 246 |
SPS−2 | 258 | 245 | 265 | 256 | 260 | 264 | 268 | 268 | 251 | 284 | 268 | 257 | 259 | 253 |
SPS−3 | 255 | 247 | 261 | 252 | 260 | 263 | 267 | 265 | 253 | 268 | 278 | 258 | 260 | 254 |
PS−1 | 258 | 248 | 259 | 255 | 260 | 266 | 267 | 268 | 249 | 257 | 258 | 282 | 270 | 265 |
PS−2 | 260 | 248 | 259 | 254 | 262 | 265 | 267 | 264 | 249 | 259 | 260 | 270 | 279 | 269 |
PS−3 | 256 | 247 | 254 | 252 | 257 | 263 | 263 | 262 | 246 | 253 | 254 | 265 | 269 | 273 |
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Tang, Q.; Yuan, M.; Wu, W.; Wu, H.; Wang, C.; Chen, G.; Li, C.; Lu, J. Health Status and Individual Care Needs of Disabled Elderly at Home in Different Types of Care. Int. J. Environ. Res. Public Health 2022, 19, 11371. https://doi.org/10.3390/ijerph191811371
Tang Q, Yuan M, Wu W, Wu H, Wang C, Chen G, Li C, Lu J. Health Status and Individual Care Needs of Disabled Elderly at Home in Different Types of Care. International Journal of Environmental Research and Public Health. 2022; 19(18):11371. https://doi.org/10.3390/ijerph191811371
Chicago/Turabian StyleTang, Qi, Min Yuan, Wenhui Wu, Huanyun Wu, Cao Wang, Gang Chen, Chengyue Li, and Jun Lu. 2022. "Health Status and Individual Care Needs of Disabled Elderly at Home in Different Types of Care" International Journal of Environmental Research and Public Health 19, no. 18: 11371. https://doi.org/10.3390/ijerph191811371